Seroprevalence of antibodies against Chlamydia trachomatis and enteropathogens and distance to the nearest water source among young children in the Amhara Region of Ethiopia
Seroprevalence of antibodies against Chlamydia trachomatis and enteropathogens and distance to the nearest water source among young children in the Amhara Region of Ethiopia
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DOI：
10.1371/journal.pntd.0008647
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发表时间：
2020-09-01
影响因子：
3.8
通讯作者：
Arnold, Benjamin F.
中科院分区：
文献类型：
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作者：
Aiemjoy, Kristen;Aragie, Solomon;Arnold, Benjamin F.
由沙眼衣原体重复感染引起的沙眼和许多肠道病原体的传播与水量有关。我们假设，居住在远离水源的儿童，通过抗体反应测定，会有较高的沙眼衣原体和肠道病原体暴露。2016年，我们使用多重微珠检测法测量了对沙眼衣原体、贾第鞭毛虫、隐孢子虫、溶组织内阿米巴、肠道沙门氏菌、空肠弯曲杆菌、肠致病性大肠杆菌（ETEC）和霍乱弧菌洗脱的干血斑的IgG抗体应答，这些血斑是从埃塞俄比亚农村40个社区的2267名0-9岁儿童中收集的。计算了从孩子的家到最近水源的直线距离。我们使用外部阴性对照人群（如果可用）或通过拟合有限混合模型推导血清阳性率临界值。我们使用有针对性的最大似然估计，根据距离最近的水源估计血清阳性率的差异。1-9岁儿童的血清阳性率为：沙眼衣原体43%，肠道沙门氏菌28%，溶组织肠球菌70%，肠球菌54%，空肠弯曲菌96%，ETEC 76%，微小念珠菌94%。所有病原体的血清阳性率随年龄增长而增加。到最近水源的中位距离为473米（IQR 268，719）。居住在离水源最远的儿童与居住在离水源最近的儿童相比，肠道沙门氏菌血清阳性率高12%（95%CI：2.6，21.6），肠道沙门氏菌血清阳性率高12.7%（95%CI：2.9，22.6）。沙眼衣原体和肠道病原体的血清阳性率很高，大多数肠道病原体在出生后的头两年明显增加。生活在远离水源的儿童有较高的血清阳性率ofS.enterica和G. pneuminalis表明，改善获得水在埃塞俄比亚的阿姆哈拉地区可能会减少暴露于这些肠道病原体在幼儿。作者摘要沙眼，感染的眼睛引起的细菌沙眼衣原体，和许多沙眼引起的感染与获得水洗手和洗脸。在人群中测量这些不同的病原体是具有挑战性的，很少同时测量多种感染。在这里，我们使用了一种综合的方法，同时测量抗体反应沙眼衣原体，贾第鞭毛虫，隐孢子虫，溶组织内阿米巴，沙门氏菌肠道，空肠弯曲杆菌，肠致病性大肠杆菌（ETEC）和霍乱弧菌居住在埃塞俄比亚农村的幼儿。我们发现，所有病原体的血清阳性率随年龄的增长而增加，并且对一种以上病原体的血清阳性是常见的。生活在远离水源的儿童更有可能暴露于肠道沙门氏菌和肠道革兰氏菌。综合血清监测是探索多种病原体暴露的复杂性以及调查水、环境卫生和个人卫生相关暴露与疾病传播之间的关联的一个有希望的途径。
The transmission of trachoma, caused by repeat infections withChlamydia trachomatis, and many enteropathogens are linked to water quantity. We hypothesized that children living further from a water source would have higher exposure toC.trachomatisand enteric pathogens as determined by antibody responses. We used a multiplex bead assay to measure IgG antibody responses toC.trachomatis,Giardia intestinalis,Cryptosporidium parvum,Entamoeba histolytica,Salmonella enterica,Campylobacter jejuni, enterotoxigenicEscherichia coli(ETEC) andVibrio choleraein eluted dried blood spots collected from 2267 children ages 0-9 years in 40 communities in rural Ethiopia in 2016. Linear distance from the child's house to the nearest water source was calculated. We derived seroprevalence cutoffs using external negative control populations, if available, or by fitting finite mixture models. We used targeted maximum likelihood estimation to estimate differences in seroprevalence according to distance to the nearest water source. Seroprevalence among 1-9-year-olds was 43% forC.trachomatis, 28% forS.enterica, 70% forE.histolytica, 54% forG.intestinalis, 96% forC.jejuni, 76% for ETEC and 94% forC.parvum. Seroprevalence increased with age for all pathogens. Median distance to the nearest water source was 473 meters (IQR 268, 719). Children living furthest from a water source had a 12% (95% CI: 2.6, 21.6) higher seroprevalence ofS.entericaand a 12.7% (95% CI: 2.9, 22.6) higher seroprevalence ofG.intestinaliscompared to children living nearest. Seroprevalence forC.trachomatisand enteropathogens was high, with marked increases for most enteropathogens in the first two years of life. Children living further from a water source had higher seroprevalence ofS.enterica and G.intestinalisindicating that improving access to water in the Ethiopia's Amhara region may reduce exposure to these enteropathogens in young children.Author summary Trachoma, an infection of the eye caused by the bacteriaChlamydia trachomatis, and many diarrhea-causing infections are associated with access to water for washing hands and faces. Measuring these different pathogens in a population is challenging and rarely are multiple infections measured at the same time. Here, we used an integrated approach to simultaneously measure antibody responses toC.trachomatis,Giardia intestinalis,Cryptosporidium parvum,Entamoeba histolytica,Salmonella enterica,Campylobacter jejuni, enterotoxigenicEscherichia coli(ETEC) andVibrio choleraeamong young children residing in rural Ethiopia. We found that the seroprevalence of all pathogens increased with age and that seropositivity to more than one pathogen was common. Children living further from a water source were more likely to be exposed toS.enterica and G.intestinalis. Integrated sero-surveillance is a promising avenue to explore the complexities of multi-pathogen exposure as well as to investigate associations between water, sanitation, and hygiene related exposures and disease transmission.